This 12 year old boy was referred by his school to a Child and Adolescent Crisis Intervention Crisis Team that I worked on. He was referred due to violent and disruptive classroom behavior that resulted in his injuring a teacher in an overcrowded inner-city middle school. I saw him in an emergency room setting.Upon evaluation, I immediately noticed two very important things in his artwork. One was the very regressed quality of the work for his age, which made me suspect a learning disability or developmental delay. The other was the chaotic nature of the artwork itself.When I questioned him about the first picture, all he told me that was that it was a picture of him looking out of the window of his house. I knew that he lived in a very bad neighborhood; the picture and his description made me think of someone peering out of an apartment building door’s “peep-hole.” I wondered if something unsafe had happened.

In the second picture, I did a preliminary screening for developmental delay and learning capacity by testing for fine motor skills and ability to focus on task. Art therapists do this in many different ways. In this case, I asked him to cut different shapes (triangles, rectangles) with scissors, and use glue to place them in certain areas. You can see from the second picture that he was unable to accomplish these tasks nearly as successfully as a 12 year old should be able to.I sent this boy for testing and he was found to be learning disabled, which the school had missed. He got into a new class and was assigned a tutor. Upon meeting his mother, I found out that she had been raped and had recently attempted suicide, so their home was in a chaotic state. This helped to explain the content of the first picture, with the boy fearfully peering out of the apartment.This family was referred for family therapy and the mother was referred to a rape crisis center. This, combined with the boy being properly placed in a special education class, hopefully put this family on a path toward health and healing.